外周血CAR、血清IL-17水平与MPP患儿病情严重程度及预后的关系  

Relationship betweenperipheral blood C-reactive protein to albumin ratio(CAR)and serum interleukin-17(IL-17)levels andthe severity and prognosis of children with mycoplasma pneumoniae pneumonia(MPP)

作　　者：周铕 李秋红 王思敏 ZHOU You;LI Qiuhong;WANG Simin(Department of Pediatric,the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Military Medical University Xijing Hospital,Xi′an 710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院西京医院儿科,西安710032

出　　处：《新疆医科大学学报》2024年第12期1604-1608,共5页Journal of Xinjiang Medical University

基　　金：陕西省卫生健康委员会计划项目(A202303108276)。

摘　　要：目的研究外周血C反应蛋白(C-reactive protein,CRP)、白蛋白(Albumin,ALB)比值(CRP to ALB ratio,CAR)、血清白介素-17(Interleukin-17,IL-17)水平与肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)患儿病情严重程度及预后的关系。方法以2022年1月-2023年12月于中国人民解放军空军军医大学第一附属医院西京医院儿科就诊并治疗的118例MPP患儿为研究对象,以同期体检的120名健康儿童为对照组。于入院当天采集患者空腹外周血,检测血清CRP、ALB和IL-17水平,计算CRP与ALB比值(CRP to ALB ratio,CAR)。对所有患儿的病情严重程度进行评估,治疗后评估患儿预后。结果与对照组比较,病例组外周血CAR和IL-17水平均升高,差异有统计学意义(P<0.05)。MPP患儿外周血CAR和IL-17水平呈显著正相关关系(r=0.374,P=0.006)。118例MPP患儿中,重症患儿51例,轻症患儿67例。与轻症组比较,重症组患儿外周血CAR和IL-17水平上升,差异有统计学意义(P<0.05)。外周血CAR诊断不同严重程度MPP的曲线下面积(AUC)为0.756(0.667~0.845),灵敏度和特异度分别为62.7%和85.1%;外周血IL-17水平诊断不同严重程度MPP的AUC为0.745(0.654~0.835),灵敏度和特异度分别为51.0%和99.1%;外周血CAR联合IL-17水平诊断不同严重程度MPP的AUC为0.913(0.862~0.964),灵敏度和特异度分别为84.3%和80.6%。51例重症MPP患儿中,14例预后不良,37例预后良好。与预后良好组比较,预后不良组外周血CAR和IL-17水平上升,差异有统计学意义(P<0.05)。外周血CAR预测重症MPP患儿不同预后的AUC为0.685(0.512~0.859),灵敏度和特异度分别为57.1%和75.4%;外周血IL-17水平预测重症MPP患儿不同预后的AUC为0.722(0.548~0.896),灵敏度和特异度分别为78.6%和78.4%;外周血CAR联合IL-17水平预测重症MPP患儿不同预后的AUC为0.764(0.620~0.909),灵敏度和特异度分别为78.6%和70.3%。结论外周血CAR、IL-17水平与MPP患儿严重程度及预后有关,且对MPP患儿不同严重ObjectiveTo investigate the clinical and prognostic implications of C-reactive protein to albumin ratio(CAR)andinterleukin-17(IL-17)in children with mycoplasma pneumoniae pneumonia(MPP).MethodsA total of 118 children with MPP who were treated in the hospital from January 2022 to December 2023 were included as as MPP group.During the same period,this researchrecruited120 children underwent physical examination in the same hospital as healthy control group.Fasting peripheral blood of the patients were collected on the day of admission.CRP,ALB and IL-17 levels were detected,and CAR was calculated.The severity of MPP was assessed in the MPP group,and the prognosis was evaluated after the treatment.ResultsCompared with control group,the levels of CAR and IL-17 in the peripheral blood of the case group wereincreased significantly(P<0.05).There was a significant positive correlation between CAR and IL-17 levels in peripheral blood of MPP patients(r=0.374,P=0.006).Among the 118 children with MPP,there were 51 severe cases and 67 mild cases.Compared with mild group,the levels of CAR and IL-17 in the peripheral blood of children in the severe group wereincreased,and the difference was statistically significant(P<0.05).The area under the curve(AUC)of peripheral blood CAR diagnosis for different severity levels of MPP was 0.756(0.667~0.845),with sensitivity and specificity of 62.7%and 85.1%,respectively.The AUC for diagnosing MPP of different severity levels based on peripheral blood IL-17 levels were 0.745(0.654~0.835),with sensitivity and specificity of 51.0%and 99.1%,respectively.The AUC of peripheral blood CAR combined with IL-17 levels for diagnosing different severity levels of MPP were 0.913(0.862~0.964),with sensitivity and specificity of 84.3%and 80.6%,respectively.Among 51 critically ill MPP patients,14 had poor prognosis and 37 had good prognosis.Compared with the group with good prognosis,the levels of CAR and IL-17 in peripheral blood of the group with poor prognosis were increased,and the difference was statist

关 键 词：C反应蛋白/白蛋白比值 白介素-17 肺炎支原体肺炎 预后 

分 类 号：R563[医药卫生—呼吸系统]